In every grade school class photo, I seem to have a mess of tousled hair on my head. No matter how much my mom tried to tame my hair, it was a little unruly. (I sported the windblown look without even trying.) Later came my metalhead phase, with headbangable hair down to the middle of my back. Sadly, though, like many of the men in my family, it started to thin, then disappear. Studies show that by age 50, approximately half of men and women will experience hair loss. Why do some lose their hair and others don’t? How can we preserve the looks of our locks?
What Causes Hair Loss?
As I discuss in my video Supplements for Hair Growth, we don’t lose our hair by washing or brushing it too much––two of the many myths out there. The majority of hair loss with age is genetic for both women and men. Based on twin studies, the heritability of baldness in men is 79%, meaning about 80% of the differences in hair loss between men is genetically determined, but that leaves some wiggle room.
Look at identical twins, for instance: Identical twin sisters with the same DNA had different amounts of hair loss, thanks to increased stress, increased smoking, having more children, or having a history of high blood pressure or cancer.
Indeed, smoking can contribute to the development of both male and female pattern baldness because the genotoxic compounds in cigarettes may damage the DNA in our hair follicles and cause microvascular poisoning in their base.
Other toxic agents associated with hair loss include mercury; it seems to concentrate about 250-fold in growing scalp hair. William Shakespeare may have started losing his hair due to mercury poisoning from syphilis treatment. Thankfully, doctors don’t give their patients mercury anymore. These days, as the Centers for Disease Control and Prevention point out, mercury mainly enters the body through seafood consumption.
Consider this: A woman went to her physician, concerned about her hair loss. Blood tests indicated elevated mercury levels, which makes sense as her diet was high in tuna. When she stopped eating tuna, her mercury levels fell and her hair started to grow back within two months. After seven months on a fish-free diet, her hair completely regrew. Doctors should consider screening for mercury toxicity when they see hair loss.
How to Prevent Hair Loss
In addition to not smoking, managing our stress, and avoiding seafood, is there anything else we can do to prevent hair loss?
We can make sure we don’t have scurvy, severe vitamin C deficiency. We’ve known for centuries that scurvy can cause hair loss, but once we have enough vitamin C so our gums aren’t bleeding, there are no data correlating vitamin C levels and hair loss. So, make sure you have a certain baseline sufficiency.
Foods for Our Hair
What about foods for hair loss? What role might diet play in the treatment of hair loss?
As I discuss in my video Food for Hair Growth, population studies have found that male pattern baldness is associated with poor sleeping habits and the consumption of meat and junk food, whereas protective associations were found for the consumption of raw vegetables, fresh herbs, and soy milk. Drinking soy beverages on a weekly basis was associated with 62% lower odds of moderate to severe hair loss, raising the possibility that there may be compounds in plants that may be protective.
A randomized, double-blind, placebo-controlled study of compounds in hot peppers and soy found significantly higher promotion of hair growth, and the doses used were reasonable: 6 milligrams of capsaicin a day and 75 milligrams of isoflavones. How does that translate into actual food? We can get 6 milligrams of capsaicin in just a quarter of a fresh jalapeño pepper a day and 75 milligrams of isoflavones eating just three-quarter cup of tempeh or soybeans.
Researchers also investigated pumpkin seeds and hair loss. For a few months, 76 men with male pattern baldness received 400 milligrams of pumpkin seed oil a day hidden in capsules (the equivalent of eating about two and a half pumpkin seeds a day) or took placebo capsules. After 24 weeks of treatment, self-rated improvement and satisfaction scores in the pumpkin group were higher, and they objectively had more hair—a 40% increase in hair counts, compared to only 10% in the placebo group. In the pumpkin group, 95% remained either unchanged or improved, whereas in the control group, more than 90% remained unchanged or worsened. Given such a pronounced effect, there was concern about sexual side effects, but researchers looked before and after at an index of erectile dysfunction and found no evidence of adverse effects.
The Best Vitamin for Hair Growth?
The most common ingredient in top-selling hair loss products is vitamin B7, also known as biotin. Biotin deficiency causes hair loss, but there are no evidence-based data that supplementing biotin promotes hair growth. And severe biotin deficiency in healthy individuals eating a normal diet has never been reported. However, if you eat raw egg whites, you can acquire a biotin deficiency, since there are compounds that attach to biotin and prevent it from being absorbed. Other than rare deficiency syndromes, though, it’s a myth that biotin supplements increase hair growth.
Can we just adopt the attitude that it can’t hurt, so we might as well see if it helps? No, because there is a lack of regulatory oversight of the supplement industry and, in the case of biotin, interference with lab tests. Many dietary supplements promoted for hair health contain biotin levels up to 650 times the recommended daily intake of biotin. And excess biotin in the blood can play haywire on a bunch of different blood tests, including thyroid function, other hormone tests (including pregnancy), and the test performed to determine if you’ve had a heart attack––so it could potentially even be life or death.
Do Hair Growth Pills Really Work?
What about drugs? We only have good evidence for efficacy for the two drugs approved by the U.S. Food and Drug Administration: finasteride, sold as Propecia, and minoxidil, sold as Rogaine. It’s considered a myth that all the patented hair-loss supplements on the market will increase hair growth. And they may actually be more expensive, with over-the-counter supplement regimens costing up to more than $1,000 a year, whereas the drugs may cost only $100 to $300 a year. As I discuss in my video Pills for Hair Growth, the drugs can help, but they can also cause side effects. Propecia can diminish libido, cause sexual disfunction, and have been associated with impotence, testicular pain, and breast enlargement, while the topical Minoxidil can cause itching, for example.
How do they work (if they work at all)? Androgens are the principal drivers of hair growth in both men and women. Testosterone is the primary androgen circulating in the blood, and it can be converted to dihydrotestosterone, which is even more powerful, by an enzyme called 5-alpha reductase. That’s the enzyme that is blocked by Propecia, so it inhibits the souping up of testosterone. This is why pre-menopausal women are not supposed to take it, since it could feminize male fetuses, whereas for men, it has sexual side effects like erectile dysfunction, which can affect men for years even after stopping the medication and may even be permanent. Indeed, up to 20% of people reporting persistent sexual dysfunction for six or more years after stopping the drug, suggesting the possibility that it may never go away.
Pass on the Pills and Reach for a Fork
Given the side effects of the current drug options, I encourage you to incorporate hair-friendly foods in your daily routine.
